"HIV Prevention Research and Infrastructure Development in Syria and Middle East" In response to PAR-08-153 ("Collaborative HIV/AIDS Studies in the Middle East"), the Center for AIDS Intervention Research (CAIR)//Medical College of Wisconsin-- in collaboration with the Center for Community Health (CCH)/University of Memphis and the Syrian Center for Tobacco Studies (SCTS)-- requests 2 years of funding to collect phase 1 quantitative and qualitative data about HIV risk behavior among STI patients and HIV-positive individuals in Syria with the goal of developing and piloting a culturally-relevant HIV/STI risk reduction intervention. Another important goal of the study is to develop HIV-relevant research infrastructure, capacity, and expertise in Syria. Specifically, we propose to conduct a formative study to develop and implement a pilot HIV/STI risk reduction intervention in Syria. In Phase 1 of the study, we aim to (1) Determine optimal strategies for accessing segments of the population at high risk for HIV/STI transmission and/or infection;and (2) Document the range and frequency of HIV/STI risk and preventive behavior and gain insight into the factors impeding or facilitating risk reduction behavior through examination of individual and interpersonal influences within a broader sociocultural and structural context. In Phase 2 of the study, we aim to (3) Develop and pilot test an HIV/STI risk reduction intervention for cultural relevance, acceptability, and feasibility in close collaboration with local stakeholders. Our research design and assessment measures will be developed in close consultation with a Community Advisory Board, comprised of influential Islamic Scholars and key health delivery and public health stakeholders in Syria. The support of local religious leaders and health care delivery systems will enhance our capacity to successfully implement evidence-based public health HIV/STI risk reduction intervention programs. Further, researchers from CAIR and CCH will work closely with researchers at SCTS in Syria to develop local HIV research infrastructure, capacity, and expertise. CAIR researchers have a long history of building local research capacity in non-U.S. countries. Likewise, researchers at CCH and SCTS have developed a very successful health behavior and epidemiological research infrastructure in Syria which has trained many local scientists and won several international awards. The Syrian Project Coordinator is the former Director of HIV Prevention Services for the Syrian Health Ministry. The respective strengths of the collective research teams provide a strong foundation to successfully develop and implement a culturally-competent program of HIV/STI prevention intervention in a low prevalence country before an epidemic emerges. Such preemptive efforts are needed to stem the continued global expansion of HIV/STIs, especially in Islamic-Arab countries of the Middle East. Findings from our study will be disseminated for use in the development of HIV/STI risk reduction interventions in Syria, as well as the broader Middle East region given the many sociocultural similarities between Syria and other Arab-Islamic countries in this region. PUBLIC HEALTH RELEVANCE: "HIV Prevention Research and Infrastructure Development in Syria and Middle East" The development and conduct of a program of culturally-competent HIV/STI prevention intervention research in a low prevalence country can preemptively stem the potential of an epidemic spread of HIV/STIs. Such preemptive efforts are needed to stem the continued global expansion of HIV/STIs, especially in Islamic- Arab countries of the Middle East. Findings from our study will be disseminated for use in the development of HIV/STI risk reduction interventions in Syria, as well as the broader Middle East region.